Monday, August 31, 2015

Near Daily Sex

We counsel married couples to 'aim for near daily sex', but what does that mean exactly?

It doesn't mean that we make love every night, seven days a week and 365 days a year! It is rather a mindset, in that our default expectation each day is that we will be making love. 

Life happens, and circumstances intervene, and some nights we are just plain tired, so in practice we probably average only 4-5 times in a normal week, and sometimes one of us is sick or travelling and we go a whole week or more without making love, but the mindset is still important - rather than our default expectation being that we will not make love unless something special happens to put us in the mood, we expect that we will make love unless something extraordinary intervenes to stop us being intimate.

And that mindset is with us through the day, so we consciously build margin into our day so that we will have the time and energy left to make love, and we think about what we want to do that night, which helps to prepare us by building anticipation and desire, and we make sure that we head up to bed early enough, and together. And C is in the habit of wearing matching and attractive lingerie every day, with the expectation that I will be undressing her later!

As I have blogged before, many (most?) women in a long-term relationship, C included, do not regularly experience spontaneous physical desire or arousal ('horniness') in the way that us guys know it. So if we waited for C to be physically 'horny' before making love we would have a whole lot less sex. But once we start making out, she quickly gets into it and gets mentally turned-on and then her physical arousal follows, from which point she wants and needs sexual release as much as I do. Aiming for near daily sex means that C is in the mindset to start making out with me even though she is probably not 'in the mood' to start with, and to see where it goes, which is usually in the right direction!

And this becomes a habit. In case you think near daily sex is only for the first passionate years of marriage, we have been married 19 years and it is part of the entrenched fabric of our marriage relationship. 

So the narrative is one of us asking if we can skip a night when we are not up for it, rather than one of us begging to do it.

Research says that it takes 66 days for a behavior to become a habit, so I challenge you to commit to 'aiming for near daily sex' for the next 66 days, and see what happens in your bedroom narrative.

Sunday, August 30, 2015

Antidepressants and anti-anxiety meds and the impact on male sexual response

This has been a surprisingly tough post for me to write, as it is very personal, but my calling for this Blog is to share on intimacy in marriage based on my personal experiences, so I feel that I have to share, even if it has taken me a while to get round to posting on this topic.

My doctor put me onto an SNRI, Lexamil (Lexapro) about two years ago as I was going through a particularly stressful period at work that was triggering episodes of anxiety and panic attacks. It worked a treat for the anxiety, but over time I started experiencing adverse side effects that began to impact negatively on my sexual response. The side effects crept up on me slowly, so like the frog in the old experiment that stays sitting placidly in a pot of water over the stove as it is heated slowly to boiling point until the frog cooks, it took me a while to put two and two together and realise the cause of the problem.

The Lexapro did not impact my libido or my ability to achieve and maintain a firm erection, but rather the intensity of sensation in my penis and eventually my ability to reach orgasm. Over time the sensation slowly became less and the intensity of my orgasms decreased, until eventually I started to not be able to reach orgasm every 2nd or 3rd time that C and I made love. This happened especially when we made love on consecutive nights or more than once in a day, which is not a problem I have ever had before. When I did orgasm, it took much longer and I really had to focus to get there, or I would get close and then 'lose it'. It got to the stage where I was sometimes not even able to orgasm from oral sex or even while masturbating.

In the beginning I think C enjoyed the extended sessions of intercourse, given her rare ability to orgasm again and again (and again and again...) for as long as intercourse lasts, but she also eventually became concerned by my increasing inability to orgasm when we made love. She likes to feel me ejaculating inside her, and while making love was still pleasurable it somehow made sex feel 'incomplete' for both of us when it did not end with my orgasm.

When I eventually made the connection to my medication and started to do some research, it all became clear that the Lexapro was the culprit. In fact, I discovered that this class of SNRI's is used as the primary treatment for men suffering from premature ejaculation! As one internet commentator put it 'it felt like my penis had been anaesthetised' and that exactly described my experience.

I think the fact that it did not impact my libido or my ability to easily achieve a firm erection is why it took me so long to identify that there was a problem and what it was. If either of those items had been affected you can bet I would have been doing my research much earlier!

When I eventually spoke with my GP he was horrified that I had not discussed this with him earlier. We agreed to stop the medication, given that my stressful work issues had largely resolved by that stage, and to see how I went without it. My anxiety has been fine and the panic attacks have thankfully not recurred, so I have stopped the Lexapro and have not switched to another class of SNRI or SSRI medication that does not have sexual side effects, which is the other treatment option for those experiencing this side effect of Lexapro.

Stopping SNRI's had a lot of its own side effects though. As the medication is stored in the gall of the liver, it can take up to 3 months to exit the system. I experienced a number of the withdrawal symptoms that are listed for Lexapro, including dizziness, difficulty in falling asleep and vivid dreams. These wore off quite quickly though over 3-4 weeks, while my sensitivity and ability to orgasm also recovered quite quickly over the same period.

Happily, the sensation in my penis and my ability to orgasm have been fully restored and are back to being as they were. It was fantastic to get the sensation back and for a period making love felt like new all over again - I had forgotten how amazingly intense a good orgasm can be! It is not something I take for granted anymore!

So if your doctor prescribes an SNRI or SSRI for you, please consider the possible sexual side effects and discuss them with your doctor before you start taking them. And if you are experiencing any of the side effects that I had, or start to experience these, please chat to your doctor sooner rather than later, as there are alternative treatment options available.

Related older post: Hormones

(Disclaimer: I am not a healthcare professional and am not qualified to give any healthcare related advice; I am writing here purely from my own experience. Please do not start or stop taking any prescription or over the counter medication without first consulting with your GP!)